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 Zambia HIV National Guidelines
 


Introduction  

HIV Counseling and Testing  

Sexually Transmitted Infections (STIs)  

General Principles of Antiretroviral Therapy for Chronic HIV Infection in Adults and Adolescents  

When to Start ARV Therapy for Chronic HIV Infection in Adults and Adolescents  

Initial Regimen for ARV Therapy  

Adherence  

Baseline evaluation and Monitoring  

Calculations: Ideal Body Weight, Body Mass Index and Creatinine Clearance  

ARV Therapy for Individuals with Tuberculosis Co-Infection  

Adverse Effects and Toxicity  

Immune Reconstitution Inflammatory Syndrome (IRIS)  

Changing or Stopping ART  

Treatment Failure  

Stopping ARV Therapy  

Post Exposure Prophylaxis  

Cotrimoxazole Prophylaxis  

WHO Staging in Adults and Adolescents  

Nutrition Care and Support  

Palliative Care in HIV and AIDS  

 Guide Editors
 Editor In Chief
    Joel E. Gallant, MD, MPH

Pharmacology Editor
    Paul Pham, PharmD, BCPS

Zambia Guideline Team
   Peter Mwaba MMed PhD FRCP
   Alywn Mwinga MMed
   Isaac Zulu MMed MPH
   Velepie Mtonga MMed
   Albert Mwango MBChB
   Jabbin Mulwanda MMed FCS
 

 

 

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When to Start ART in Adults and Adolescents

04-10-2008
Adults and Adolescents with Documented HIV Infection

  • WHO stage I*:
  • CD4 available: use CD4-guided criteria (see below)
  • CD4 not available: do not treat
  • WHO stage II:
  • CD4 available: use CD4-guided criteria
  • CD4 not available: treat if total lymphocyte count <1200 (CD4 count strongly recommended)
  • WHO Stage III:
  • CD4 available: treat if CD4 <350. If CD4 >350, treat if >1 stage 3 sign or repeated stage 3 problem
  • CD4 not available: treat
  • WHO Stage IV: treat regardless of CD4
  • *For WHO clinical stages of see WHO Clinical Staging of HIV Disease in Adults and Adolescents 
CD4 Criteria for Initiation of ART

  • CD4 <200: Treat regardless of clinical stage
  • CD4 200-350: Treat if WHO stage III or pregnancy
  • CD4 >350: Treat if >1 stage III sign or repeated stage III conditions. For others, monitor and consider ART based on clinical or immunologic deterioration. Always start before CD4 decreases to <200.
  • Measure CD4 after stabilization of any intercurrent illness.

 
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Zambia HIV National Guidelines

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